Provider Demographics
NPI:1902176902
Name:SABALBORO, GERALDYN REYES BANDOLA (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:GERALDYN
Middle Name:REYES BANDOLA
Last Name:SABALBORO
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:22545 BARTON RD
Mailing Address - Street 2:SUITE #107
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-5030
Mailing Address - Country:US
Mailing Address - Phone:909-583-1267
Mailing Address - Fax:
Practice Address - Street 1:22545 BARTON RD
Practice Address - Street 2:SUITE #107
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5244
Practice Address - Country:US
Practice Address - Phone:909-583-1267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist